title: Peripartum anesthetic management of renal transplant patients--a multicenter cohort study.
abstract: As the number and success of renal transplantation has grown, there has been an increase in the number of renal transplant patients giving birth. To date, there has been no data on obstetric anesthesia management of these patients. The purpose of this study was to build an Israeli national database on parturients after renal transplant. A sixteen-year (calendar years 1996-2011) retrospective study was conducted at three major tertiary centers with a combined current birth rate of approximately 25,000 deliveries annually. We found 83 labors in 64 women. Forty-two percent of this population suffered from hypertension while 12.5% had diabetes. Forty-seven percent of women had a vaginal delivery while 53% of women had a cesarean section. The rate of epidural analgesia for labor was 59%, and rate of regional anesthesia during cesarean section was 75%. There were no anesthetic complications in any cases. Standard ASA monitoring was used in all cases except for one woman with severe hypertension who required an arterial line during her cesarean section. Forty-seven percent of newborn were under 37 weeks with average gestational week 36 ± 3 days and birth weight 2.5 ± 0.7 kg. Average Apgar was 8.4 ± 1.3 at one minute and 9.3 ± 0.7 at five minutes. There was one neonatal death in the CS group due to placental abruption. Patients after renal transplant can safely undergo birth and obstetric analgesia.
authors.affiliation: Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Hebrew University Jerusalem , Israel .
authors.forename: A
authors.initials: A
authors.lastname: Ioscovich
authors.forename: S
authors.initials: S
authors.lastname: Orbach-Zinger
authors.forename: D
authors.initials: D
authors.lastname: Zemzov
authors.forename: A
authors.initials: A
authors.lastname: Reuveni
authors.forename: L A
authors.initials: LA
authors.lastname: Eidelman
authors.forename: Y
authors.initials: Y
authors.lastname: Ginosar
mesh_terms: D000293:Adolescent; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods* / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016030:Kidney Transplantation / Q000534:rehabilitation; D007743:Labor, Obstetric; D058725:Peripartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000628:therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult